Objective To analyze the distribution characteristics and trends of occupational exposure types of medical radiation workers in Gansu Province, China, and to provide a basis for administrative departments to formulate and adjust radiation protection policies. Methods According to the radiation health information platform, the data of occupational exposure types of radiation workers in Gansu Province from 2014 to 2023 were obtained. The proportions of occupational exposure types in each physical examination year was statistically analyzed. Results From 2014 to 2023, the number of medical radiation workers accounted for more than 70% of the total number of radiation workers. The proportion of X-ray imaging diagnostic radiation workers in the total number of medical radiation workers gradually decreased but remained the highest, exceeding 68% annually. The proportion of interventional radiology workers in the total number of medical radiation workers increased from 13.8% to 25.5%. The proportions of radiation therapy and nuclear medicine workers in the total number of medical radiation workers increased slowly. The numbers of interventional radiology and radiotherapy workers in tertiary hospitals both accounted for more than 70% of the total number of such workers in the province. The proportion of interventional radiology workers increased and then decreased. The proportion of radiotherapy workers increased significantly from 70.5% to 93.0%. The number of nuclear medicine workers in tertiary hospitals accounted for more than 80% of such workers in the province. Conclusion Radiation protection policies and measures should be adjusted according to the changes in the types of occupational exposure. The focus of these policies and measures should differ depending on the level of healthcare institutions, the type of radiological diagnostic and therapeutic services, and the characteristics of various occupational exposure types .

Objective To analyze micronucleus abnormalities in the peripheral blood lymphocytes of industrial radiation workers and the influencing factors, and to provide a reference for radiation protection. Methods The occupational health monitoring data of 661 industrial radiation workers were collected from the occupational health examination system of Gansu Provincial Center for Disease Control and Prevention. The abnormalities in the micronucleus of peripheral blood lymphocytes were analyzed. The influencing factors were identified by logistic regression. Results The micronucleus abnormality rate was 6.05% for the 661 industrial radiation workers. There was no significant difference in micronucleus abnormality rate between sexes (P > 0.05). Comparison of age groups showed that the rate of micronucleus abnormality increased with age, and workers over 50 years of age has the highest rate of micronucleus abnormalities (17.81%); there was a significant difference between age groups (P < 0.05). There was a significant difference in micronucleus abnormality rate between occupational categories (P < 0.05). There was a significant difference in micronucleus abnormality rate between groups with different years of work (P < 0.05). Logistic regression analysis showed that age and years of work were the risk factors for micronucleus abnormality rate (P < 0.05); age was an independent risk factor for micronucleus abnormality rate (P < 0.05). Conclusion The effect of low-dose ionizing radiation on micronucleus abnormality rate of industrial radiation workers is related to age and working years. Attention should be paid to occupational health monitoring of radiation workers, especially those with advanced age.

Objective To explore the correlation between intestinal dose and acute radiation enteritis(ARE)in patients with cervical cancer received concurrent chemoradiotherapy,and optimize the dose limit of intestinal tissue.Methods 158 cervical cancer patients received concurrent chemoradiotherapy from 2014 to 2019 were selected in this study.According to CTCAE 5.0,patients with ARE≥grade 2 were classified as ARE≥grade 2 group,otherwise classified as ARE0.7,P<0.05).Conclusions For patients with cervical cancer received concurrent chemoradiotherapy,the dose of bowelbag V5 and V40 should be considered to rationally optimize the dose of bowelbag in the radiotherapy plan,so as to reduce the incidence of ARE≥grade 2.

Objective To explore the impact of the intervention model based on self-efficacy theory on fear of progression (FoP), negative emotions, and cancer-related fatigue in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization (TACE). Methods The clinical data of 94 patients with primary liver cancer were retrospectively analyzed. The patients were divided into control group and observation group according to different intervention methods, with 47 patients in each group. The control group received routine nursing mode after discharge, while the observation group received intervention model based on self-efficacy theory. Both groups were intervened for 3 months after discharge. The self-efficacy[General Self-Efficacy Scale (GSES)]at discharge and one- and three-month after discharge, FoP[Fear of Progression Questionnaire-Short Form (FoP-Q-SF)], negative emotions[Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS)], cancer-related fatigue[Revised Piper Fatigue Scale (R-PFS)], and quality of life[Quality of Life Questionnaire for Liver Cancer Patients (QOL-LC V2.0)] at discharge and three-month after discharge were compared between the two groups. Results One month and three months after discharge, the GSES scores of both groups gradually increased compared to those at discharge, and the scores of the observation group were higher than those of the control group (P < 0.05). Three months after discharge, the total and sub-dimension scores of FoP-Q-SF, SAS scores, SDS scores, and R-PFS were lower in both groups compared to those at discharge, and the observation group had lower scores than the control group (P < 0.05). Three months after discharge, the total and sub-dimension scores of QOL-LC V2.0 were higher in both groups compared to those at discharge, and the observation group had higher scores than the control group (P < 0.05). Conclusion The intervention model based on self-efficacy theory can enhance the self-efficacy of patients with primary liver cancer after TACE, relieve negative emotions and severity of FoP, improve cancer-related fatigue, and enhance the quality of life.

Objective To investigate the effects of occupational exposure to ionizing radiation on blood indicators of radiation workers, and to provide evidence for occupational health monitoring. Methods This study included 3853 radiation workers who participated in occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 1, 2021 to December 31, 2022. The results of fasting blood glucose, renal function, liver function, white blood cell count, platelet count, and lymphocyte micronucleus were analyzed. Results The detection rates of abnormal fasting blood glucose and liver function were significantly higher in males than in females (P < 0.05), and the detection rates of abnormal renal function, white blood cell count, platelet count, and lymphocyte micronucleus were significantly lower in males than in females (P < 0.05). The detection rates of abnormal fasting blood glucose, liver function, and lymphocyte micronucleus were significantly higher in radiation workers with ≥ 21 years of working experience than those with ≤ 10 years of working experience (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the non-medical group than in the diagnostic radiology, radiation therapy, and interventional radiology groups (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the primary medical institution group than in the tertiary medical institution group (P < 0.05). The detection rate of abnormal liver function was significantly higher in the primary medical institution group than in the secondary and tertiary medical institution groups (P < 0.05). Conclusion Long-term occupational exposure to ionizing radiation may cause radiation damage to the human body. Health education should be strengthened for non-medical and male radiation workers to prevent the occurrence of chronic metabolic diseases.

Objective To investigate the effects of occupational exposure to ionizing radiation on blood indicators of radiation workers, and to provide evidence for occupational health monitoring. Methods This study included 3853 radiation workers who participated in occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 1, 2021 to December 31, 2022. The results of fasting blood glucose, renal function, liver function, white blood cell count, platelet count, and lymphocyte micronucleus were analyzed. Results The detection rates of abnormal fasting blood glucose and liver function were significantly higher in males than in females (P < 0.05), and the detection rates of abnormal renal function, white blood cell count, platelet count, and lymphocyte micronucleus were significantly lower in males than in females (P < 0.05). The detection rates of abnormal fasting blood glucose, liver function, and lymphocyte micronucleus were significantly higher in radiation workers with ≥ 21 years of working experience than those with ≤ 10 years of working experience (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the non-medical group than in the diagnostic radiology, radiation therapy, and interventional radiology groups (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the primary medical institution group than in the tertiary medical institution group (P < 0.05). The detection rate of abnormal liver function was significantly higher in the primary medical institution group than in the secondary and tertiary medical institution groups (P < 0.05). Conclusion Long-term occupational exposure to ionizing radiation may cause radiation damage to the human body. Health education should be strengthened for non-medical and male radiation workers to prevent the occurrence of chronic metabolic diseases.

ObjectiveTo systematically analyze international disability data policies and standards, as well as the application of disability data in policymaking, service optimization and inclusive social development, and to clarify the importance of international disability data policies, standard systems and disability data application for the development of disability-related services. MethodsThrough the analysis of policy content and research on the data standard system, this study explored the disability data policy framework, standard system and technical path of data interoperability and integration of international organizations including the United Nations (United Nations Statistics Division and United Nations Children's Fund), World Health Orgnization, United Nations Educational Scientific and Cultural Organization, and International Labour Organization. ResultsInternational organizations established disability data policy frameworks based on their respective mandates, involving data and service development, data standards, data governance, and data application. The international community established a disability data standard system for disability data collection, coding, exchange, interoperability, statistical analysis, data fusion and application. Building a standardized disability data standard system based on the framework of international health classification standards such as International Classification of Functioning, Disability and Health, and International Classification of Diseases, Eleventh Revision would ensure the consistency of cross-national disability data policies, and the interoperability and comparability of disability data, promoting the development of data-driven disability-related services, accurately identifying the service needs of people with disabilities, and optimizing service provision, thereby improving the quality of life and social participation of people with disabilities. ConclusionThe construction and implementation of international disability data policies and data standards have promoted the standardization and interoperability of disability data. With the application of big data, artificial intelligence and blockchain technologies in disability data, international cooperation and cross-industry data fusion in the field of disability data have been promoted, further promoting the development of data-driven disability services, ensuring equal opportunities for people with disabilities to enjoy service resources, and improving the coverage and quality of disability services.

Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.

Objective:To explore the application effect of case-based learning (CBL), teaching mode combined with 3D printing in clinical teaching of sacral tumors.Methods:A total of 108 undergraduate interns and standardized residency training students who studied in our hospital from 2017 to 2018 were divided into the CBL teaching group ( n = 53) and the CBL combined with 3D printing teaching group ( n = 55) according to their study time. The combined teaching group used computer tomography (CT) data to reconstruct and print out a 3D model of sacral tumors based on CBL, and performed preoperative teaching on the invasion of the surrounding tissues of the tumor. The scores of the students in the two groups were evaluated respectively, and the students were surveyed by self-identification questionnaire (learning interest, self-learning ability, teamwork ability, comprehensive analysis ability and clinical thinking ability). The t-test (one-sided) was used for comparison between groups using stata 14.0. Results:The score of CBL teaching group (75.90±6.70) was lower than that of CBL combined with 3D printing teaching group (83.60±7.40). In terms of critical thinking ability evaluation, self-learning ability, learning interest, comprehensive analysis ability and clinical thinking ability, the CBL combined 3D printing teaching group was superior to the CBL teaching group, and the difference was statistically significant ( P<0.001). In terms of teamwork ability, there was no statistical difference between the two groups. Conclusion:The CBL teaching mode combined with 3D printing can improve academic performance, students' learning interest and clinical thinking ability of sacral tumors in the teaching of undergraduate interns and standardized residency training students.

Objective:To explore the influencing factors of whole blood cells and genetics of medical radiation workers, and provide technical support for improving occupational health management and strengthening radiation protection.Methods:In January 2022, a total of 4180 medical radiation workers who underwent occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 2020 to December 2021 were collected as the research objects, and the results of demographic characteristics, whole blood cells, chromosome aberrations, lymphocyte micronucleus and other results were collected. The whole blood cells and genetic abnormalities of different demographic characteristics of medical radiation workers were compared. And the influencing factors of whole blood cells and genetic abnormalities were analyzed by multivariate logistic regression.Results:The rates of hemoglobin (HGB), chromosome aberration and lymphocyte micronucleus abnormality were the highest in the nuclear medicine group, and the rate of white blood cell (WBC) abnormality in the radiotherapy group was higher than those in other occupational groups, the differences were statistically significant ( P<0.05). The abnormal rates of WBC, HGB and lymphocyte micronucleus in female radiation workers were significantly higher than those in male radiation workers ( P<0.001). The abnormal rates of HGB and lymphocyte micronucleus were statistically different among different working years and different age radiation workers ( P<0.001). And the abnormal rate of platelet (PLT) was statistically different among different working years radiation workers ( P<0.05). The abnormal rate of HGB in radiation workers of different hospital levels was statistically different ( P<0.001). Logistic regression analysis showed that the risk of abnormal WBC and HGB in females radiation workers were 3.048 times and 13.122 times of those in males, respectively ( P<0.001). The abnormal risks of WBC in the 6-20 working years group and >20 working years group were 1.517 times and 1.874 times of that in the ≤5 working years group, respectively ( P<0.05). The abnormal risk of PLT in the >20 working years group was 2.643 times of that in ≤5 working years group ( P<0.05). The abnormal risk of WBC in radiotherapy group and intervention group were 2.407 times and 1.341 times of that in general radiotherapy group, respectively ( P<0.05) . Conclusion:Ionizing radiation has different effects on the whole blood cells and genetic indexes of workers in the nuclear medicine, interventional group and radiotherapy group. The occupational health protection of female radiation workers should be paid attention to.